Our results demonstrating a decrease to level of VAT <140 cm2 in normal weight subjects (BMI 18.5 to <25 kg/m2) with VAT ≥140 cm2 at baseline may have important clinical implications as a significant proportion of HIV-infected patients may present with sarcopenic obesity [50], which could be due to a reduced GHRH secretion, resulting in decreased GH synthesis, and subsequently, lower hepatic production of IGF-1 [51]. Here, IGF1 is linked to obesity due to melanocortin 4 receptor deficiency.